Optimism Levels Are Moderate and Similar in Patients with Axial Spondyloarthritis and Chronic Low Back Pain, and Are Related to Mental Quality of Life but Not Physical Quality of Life. a Cross Sectional Study of 277 Patients

Sarah Kreis^1,2,3, Anna Molto^2,3, Florian Bailly^2,3, Sabrina Dadoun^2,3, Stephanie Fabre^2,3,4, Christophe Hudry², Franck Zenasni⁵, Sylvie Rozenberg^2,3, Edouard Perthuiset⁴, Bruno Fautrel^2,6 and Laure Gossec^2,7, ¹Institut de Psychologie, Laboratoire de Psychopathologie et Processus de Santé EA4057, Université Paris Descartes, Boulogne-Billancourt, France, ²Sorbonne Universités, UPMC Univ Paris 06, GRC-08, Institut Pierre Louis d’Epidémiologie et de Santé Publique, paris, France, ³Pitié-Salpêtrière Hospital, AP-HP, Rheumatology department, paris, France, ⁴Pontoise University Hospital, pontoise, France, ⁵Institut de Psychologie, Laboratoire de Psychopathologie et Processus de Santé EA4057, Université Paris Descartes, Paris, France, Boulogne-Billancourt, France, ⁶Rheumatology, Pitie Salpetriere Hospital, Paris, France, ⁷Rheumatology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: axial spondyloarthritis, chronic low back pain, optimism and quality of life

Session Information

Title: Spondyloarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment I

Session Type: Abstract Submissions (ACR)

Background/Purpose

Axial Spondyloarthritis (AxSpA) and chronic low back pain (LBP) are very different chronic rheumatic diseases in terms of physiopathology and prognosis but both have a strong impact on patients’ health-related quality of life (HRQoL). Dispositional optimism is defined as a stable personality trait consisting of a general positive mood or attitude about the future with a tendency to expect favorable outcomes in life situations. It has been shown in some chronic disease groups (e.g cancer) that dispositional optimism is related to both physical and psychological outcomes and seems to lead to better HRQoL. The objective of this study was to explore the relationship between optimism and HRQoL in both chronic diseases: AxSpA and LBP.

Methods

A cross-sectional study was performed in two tertiary care hospitals and two private practices in France. Patients were diagnosed with definite AxSpA or chronic LBP according to the rheumatologist. HRQoL was collected using a generic HRQoL questionnaire (Short Form, SF-12) with physical and mental composite scores (PCS and MCS respectively) and optimism was collected using the Life Orientation Test-revised (LOT-R) questionnaire. Analyses included descriptive statistics, non-parametric correlations and multiple regression analyses to study the effect of optimism on physical and mental HRQoL.

Results

In all, 277 patients (188 AxSpA and 89 LBP) were included: mean age, 47.3±11.9 years, 49.1% were males. BASDAI in AxSpA was 3.8±2.0 and the LBP patients’ pain visual analog scale was 4.3±2.3. HRQoL was similarly altered in both diseases, for both physical and mental composite scores (mean PCS: 43.4±8.4 vs. 41.9±7.1; mean MCS: 45.7±7.9 vs. 46.7±8.1 for AxSpA and LBP respectively). Optimism was moderate and similar in both populations. Optimism was positively correlated to MCS in both diseases (r=0.57 vs. 0.54, for AxSpA and LBP respectively, both p<0.0001) and these relations persisted in multivariate analyses (beta=0.77 vs. 1.21, both p<0.0001).

Conclusion

Optimism was similar in these two chronic diseases and was an explanatory factor of mental HRQoL, but not physical HRQoL. Physical HRQoL may reflect more the disease process than character traits.

Disclosure:

S. Kreis,
None;

A. Molto,
None;

F. Bailly,
None;

S. Dadoun,
None;

S. Fabre,
None;

C. Hudry,
None;

F. Zenasni,
None;

S. Rozenberg,
None;

E. Perthuiset,
None;

B. Fautrel,
None;

L. Gossec,
None.

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